Experienced emotional burden in caregivers: psychometric properties of the Involvement Evaluation Questionnaire in caregivers of brain injured patients

Abstract

Objective: To examine the psychometric properties (internal consistency, discriminant validity, and responsiveness) of the Involvement Evaluation Questionnaire for Brain Injury measuring emotional burden in caregivers of patients with chronic acquired brain injury.

Design: Inception cohort study.

Subjects: Caregivers of chronic acquired brain injury patients.

Main measures: Besides the Involvement Evaluation Questionnaire for Brain Injury, the Family Assessment Device and the General Health Questionnaire were used.

Methods: Ninety-eight caregivers filled out all questionnaires, of which 41 caregivers did this twice, before and after the persons they cared for had started a residential community reintegration programme. Cronbach’s alpha and Intra class Correlation Coefficient were calculated for internal consistency. Pearson correlation coefficients were used for discriminant validity and Intra class Correlation Coefficient and Cohen’s d were calculated to determine responsiveness.

Results: The internal consistency of the Involvement Evaluation Questionnaire for Brain Injury was good (α = 0.73—0.84; Intra class Correlation Coefficient = 0.69—0.76). As expected, low correlations were found between the Involvement Evaluation Questionnaire for Brain Injury and either the General Health Questionnaire (r = 0.11—0.40) or the Family Assessment Device subscales (r = —0.29—0.19). Regarding responsiveness of the Involvement Evaluation Questionnaire for Brain Injury, a moderate effect size was found (Cohen’s d = 0.36) while the Intra class Correlation Coefficient was good (0.80).

Conclusions: The Involvement Evaluation Questionnaire for Brain Injury measures the experienced emotional burden in caregivers of patients with chronic acquired brain injury and seems to be a promising new instrument with good internal consistency, discriminant validity and responsiveness.

Get full access to this article

View all access options for this article.

References

Riley GA Stress and depression in family cares following traumatic brain injury: the influence of beliefs about difficult behaviours. Clin Rehabil 2007; 21: 82-8.

Visser-Meily JMA , van Heugten CM , Post MWM , Schepers VM , Lindeman E. Intervention studies for caregivers of stroke survivors, a critical review. Patient Educ Couns 2005; 56: 257-67.

Kreutzer JS , Rapport LJ , Marwitz JH , Harrison-Felix C. , Hart T. , Glenn M. et al. Caregivers’ well-being after traumatic brain injury: a multicenter prospective investigation. Arch Phys Med Rehabil 2009; 90: 939-46.

van Wijngaarden B. , Schene A. , Koeter M. Caregiver consequences in The Netherlands and other European countries: the development and use of the Involvement Evaluation Questionnaire. In Lefley HP , Johnson DL eds. Family interventions in mental illness. International perspectives. Westport CT: Praeger Publishers, 2002, 145-69.

Visser-Meily JMA , Post MWM , Riphagen II , Lindeman E. Measures used to assess burden among caregivers of stroke patients: a review. Clin Rehabil 2004; 18: 601-23.

Carnevale GJ , Anselmi V. , Busichio K. , Millis SJ Changes in rating of caregiver burden following a community-based behaviour management program for persons with traumatic brain injury. J Head Trauma Rehabil 2002; 17: 83-95.

van Wijngaarden B. , Schene AH , Koeter M. , Vazquez-Barquera JL , Knudsen HC , Lasalvia A. , McCrane P. and the Epsilon Study Group. Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire - European Version. Br J Psych 2000; 177: s21-s27.

Winstanley J. , Simpson G. , Tate R. , Myles B. Early indicators and contributors to psychological distress in relatives during rehabilitation following severe traumatic brain injury: findings from the brain injury outcomes study. J Head Trauma Rehabil 2006; 21: 453-66.

Wenniger WF , Hageman WJ , Arrindell WA Cross-national validation of dimensions of family functioning: first experiences with the Dutch version of the McMaster Family Assessment Device . Pers Ind Diff 1993; 14: 769-81.

10.

Miller IW , Epstein NB , Bishop DS , Keitner GI The McMaster Family Assesment Device: Reliability and validity. J Marital Fam Ther 1985; 11: 345-56.

11.

Goldberg DP , Gater R. , Sartorius N. , Ustun TB , Piccinelli M. , Gureje O. et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 1997; 27: 191-7.

12.

van Wijngaarden B. , Koeter M. , Knapp MRJ , Tansella M. , Tornicroft G. , Vazquez-Barquero JL et al. Caring for people with depression or with schizophrenia: are the consequences different? Psych Res 2009; 169: 62-9.

13.

Davis LC , Sander AM , Struchen MA , Sherer M. , Nakase-Richardson R. , Malec JF Medical and psychosocial predictors of caregiver distress and perceived burden following traumatic brain injury. J Head Trauma Rehabil 2009; 24: 145-54.

14.

Geurtsen GJ , Martina JD , van Heugten CM , Geurts ACH. A prospective study to evaluate a new residential community integration programme for severe chronic brain injury: The Brain Integration Programme. Brain Inj 2008; 22: 545-54.

15.

Geurtsen GJ , van Heugten CM , Martina JD , Meijer R. , Geurts ACH. A prospective controlled study to evaluate a residential community reintegration programme for chronic brain injury. Part I: independent living and societal participation (submitted).

16.

van Wijngaarden B. , Schene A. , Koeter M. , Becker T. , Knapp MRJ , Knudsen HC et al. People with schizophrenia in five countries: conceptual similarities and intercultural differences in family caregiving . Schizophr Bull 2003; 29: 573-86.

17.

Stam H. , Cuijpers P. Effect of family interventions on burden of relatives of psychiatric patients in The Netherlands: a pilot study. Comm Mental Health J 2001; 37: 179-87.

18.

Epstein NB , Baldwin LM , Bishop DS The McMaster Family Assessment Device. J Marital Fam Ther 1983; 9: 171-80.

19.

Aarons GA , McDonald EJ , Conneley CD , Newton RR Assessment of family functioning in Caucasian and Hispanic Americans: reliability, validity, and factor structure of the Family Assessment Device . Fam Process 2007; 46: 557-69.

20.

Ergh TC , Papport LJ , Coleman RD , Hanks RA Predictors of caregiver and family functioning following traumatic brain injury: social support moderates caregiver distress. J Head Trauma Rehabil 2002; 17: 155-74.

21.

Nabors N. , Seacat J. , Rosenthal M. Predictors of caregiver burden following traumatic brain injury. Brain Inj 2002; 16: 197-203.

22.

Goldberg D. , Williams P. A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson , 1988.

23.

Boyle GJ

Does item homogeneity indicate internal consistency or item redundancy in psychometric scales?

Pers Ind Diff 1991 ; 12: 291-4.

24.

Walters SJ , Brazier JE Comparison of the minimal important difference for two health state utility measures: EQ5D and SF6D. Qual Life Res 2005 ; 14: 1523-32.